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Ministry of Education, Science, Youth and Sports of Ukraine




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Ministry of Education, Science, Youth and Sports of Ukraine

Admiral Makarov National University of Shipbuilding

^ Educational Scientific Center of International Cooperation

For Office Use Only

Resolution

Application Form

Photo

for Invitation



Undergraduate, Graduate and Postgraduate

International Students

Officer Signature ________________


^ PERSONAL DETAILS

Date:__________________________

Name and contact information

NAME: (Write your full legal name, without abbreviation, as it appears on such official documents as school records, test scores, passport, etc.)










^ Family (last) name

First name

Middle name



































^ Other family names which might appear on documents

Male

Female

Day

Month

Year




Sex

Date of birth

























^ Citizen of what country?

Country of birth

Nationality

Place of birth City, province, etc.






















^ Passport No.




I do not have foreign passport, since it will be made out after reception of the invitation















^ Degrees already received (the completed)

 Secondary education  Bachelor  Specialist
 Master  Ph.D.  Other ________________













^ Intended major field of study at the University




Degree

 Bachelor  Specialist

 Master  Ph.D.













^ CONTACT ADDRESS (HOME)







^ Number and street name

City/Suburb



















^ Province or State

Zip or Postal Code

Country










Telephone










Fax













^ Country Code

Area Code

Local number













E-mail













^ VISA STATUS

Citizenship: _________________


Do you have a visa?

  • Yes

  • No




Citizen/visa (fill in only one)

  • F-1 Student (in Ukraine code "O")

  • Ukraine Citizen

  • Permanent Resident

  • Other: ____________________

If you have visa please, write its issue authority and place, registration Data

(embassy, country, city)








I, hereby declare that the information given by me in this application form to the best of knowledge is true. I do hereby declare that I bear full responsibility to follow the Laws of Ukraine and of my Country. The University reserves the right to expel me at any stage of the course on charges of misconduct/irregularity or indiscipline. My aim is to travel to Nikolaev, Ukraine is solely for the studies in Admiral Makarov National University of Shipbuilding, Ukraine.




Applicant's Signature:




Date:







NOTE: Please read carefully the enclosed Application Information for International Students before completing this form. Complete this form and return a copy to the Educational Scientific Center of International Cooperation via: e-mail idept@nuos.edu.ua , fax: +380-512-424811 or post address:

ESCIC, Admiral Makarov National University of Shipbuilding, 9, Geroev Stalingrad Ave., Nikolaev, 54025, Ukraine.

Application form in original you have to present at arrival.

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